Diphtheritic myocarditis: clinical and laboratory parameters of prognosis and fatal outcome.
Of the 97 throat smear-positive cases of diphtheria treated, 16 developed evidence of myocarditis (16.5%). Age, duration of illness prior to admission, anatomical extent of membrane formation, total leukocyte count and serum glutamic oxalo-acetic transaminase (SGOT) levels were analysed in fatal and non-fatal cases and the differences between the two groups found to be statistically significant with regard to anatomical extent of membrane formation, total leukocyte count and SGOT levels. The extension of membrane formation to two or more sites was a highly sensitive predictor of mortality. A total leukocyte count > 25,000 cells/mm3 had a high specificity and positive predictive value while SGOT levels of > 80 IU/l had high sensitivity and a negative predictive value.